Arrhythmias & electrophysiology
Shifting sites of care in electrophysiology: Trends and cost differences in device implantation procedures across ambulatory and hospital settings in the Medicare population
Authors' conclusion
The use of ASCs for EP device implantation is increasing and is associated with substantially lower Medicare payments without affecting physician reimbursement. These findings highlight opportunities for cost savings and support the case for expanded ASC utilization and site-neutral payment reform.
Study context
- Population
- Medicare fee-for-service beneficiaries undergoing pacemaker and implantable cardioverter-defibrillator (ICD) implantations, 2016 to 2023
- Exposure
- Payment comparisons between ASC and HOPD settings
- Outcome
- Pacemaker volumes per 10,000 beneficiaries
- Follow-up
- 2016 to 2023
Methodological details100% Medicare fee-for-service claims data
- 100% Medicare fee-for-service claims data
Main finding
As reported in the abstract
Declined from 47.2 to 44.2 per 10,000 beneficiaries
47.2 to 44.2
Observational data: associations, not effects.
Further findings
| Outcome | HOPD | ASC | Estimate |
|---|---|---|---|
| Medicare reimbursement for device implantations, ASCs vs HOPDs · 2023Less in ASCs | 15%-26% | ||
| Dual-chamber pacemaker implantation (Current Procedural Terminology code 33208) cost · 2023 | $10,673 | $8131 |
ICD volumes per 10,000 beneficiaries · 2016 to 2023
- Declined from 22.8 to 16.6 per 10,000
- 22.8 to 16.6
ASC utilization · 2016 to 2023
- Pacemakers
- 1.5% to 7.2%
- ICDs
- 1.4% to 6.9%
- P < .001 for both trends
Aggregate Medicare savings from shifting 5 electrophysiology (EP) procedures to ambulatory surgery centers (ASCs) · 2023
- Aggregate Medicare savings
- $59.3 million
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →